| NPI | 1992901482 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: FL 9370330) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 721508) | 
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9370330) | |
| Enumeration Date | 2007-06-22 | 
| Last Update Date | 2021-01-25 |